Chest Research Foundation CRF

Pune, India

Chest Research Foundation CRF

Pune, India
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Khafaie M.A.,Ahvaz Jundishapur University of Medical Sciences | Salvi S.S.,Chest Research Foundation CRF | Yajnik C.S.,King Edward Memorial Hospital Research Center | Ojha A.,Technogreen Environmental Solutions | And 2 more authors.
Environmental Science and Pollution Research | Year: 2017

Diabetics may be more vulnerable to the harmful effects of ambient air pollutants than healthy individuals. But, the risk factors that lead to susceptibility to air pollution in diabetics have not yet been identified. We examined the effect of exposure to ambient PM10 on chronic symptoms and the pulmonary function tests (PFT) in diabetic and non-diabetic subjects. Also, to investigate possible determinants of susceptibility, we recruited 400 type 2 diabetic and 465 healthy subjects who were investigated for chronic respiratory symptoms (CRSs) and then underwent measurement of forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) according to standard protocol. Percent predicted FEV1 and FVC (FEV1% and FVC%, respectively) for each subject were calculated. Particulate matter (PM10) concentrations at residence place of subjects were estimated using AERMOD dispersion model. The association between PM10 and CRSs was explored using logistic regression. We also used linear regression models controlling for potential confounders to study the association between chronic exposure to PM10 and FEV1% and FVC%. Prevalence of current wheezing, allergy symptom, chest tightness, FEV1/FVC <70%, and physician-diagnosed asthma and COPD was significantly higher among diabetic subjects than non-diabetics. There was no significant difference between percent predicted value of PFT among diabetic and non-diabetic subjects (P < 0.05). We estimated that 1 SD increase in PM10 concentration was associated with a greater risk of having dyspnea by 1.50-fold (95% CI, 1.12–2.01). Higher exposure to PM10 concentration was also significantly associated with lower FVC%. The size of effect for 1 SD μg/m3 (=98.38) increase in PM10 concentration was 3.71% (95% CI, 0.48–4.99) decrease in FVC%. In addition, we indicated that strength of these associations was higher in overweight, smoker, and aged persons. We demonstrated a possible contribution of air pollution to reduced lung function independent of diabetes status. This study suggests that decline in exposure may significantly reduce disease manifestation as dyspnea and impaired lung function. We conduct that higher BMI, smoking, and older age were associated with higher levels of air pollution effects. © 2017 Springer-Verlag Berlin Heidelberg


Ghoshal A.G.,National Allergy Asthma Bronchitis Institute NAABI | Salvi S.,Chest Research Foundation CRF | Dhar R.,National Allergy Asthma Bronchitis Institute NAABI | Dhar R.,Fortis Hospitals | And 4 more authors.
Journal of Association of Physicians of India | Year: 2017

Recent years have seen an increase in the use of nebulizers for delivering maintenance therapy in obstructive airway diseases (OADs) such as asthma and chronic obstructive pulmonary disease (COPD). The probable factors associated with this increase at home are: convenience of drug delivery, technological advances making the nebulizer equipment more efficient and portable, increase in the prevalence of OADs and the ageing population which may impact the optimal use of handheld inhalers such as pressurized metered dose inhalers (pMDIs) and dry powder inhalers (DPIs). Although there is increase in the use of maintenance therapy with nebulization, there has been no such increase in the evidence base available for the appropriate use of nebulizers. The last international guidelines were published in 2001. Hence there is a need to address this knowledge gap especially with the widespread use of home nebulization in India. With this objective, we organized a consensus meeting to address certain critical questions pertaining to the use of nebulizers for maintenance treatment in OADs. This article presents the findings of the consensus panel on the use of maintenance treatment of OADs with nebulization at home. © 2017, Journal of Association of Physicians of India. All rights reserved.

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